>Nope, none of the stuff you mentioned falls under COGS.

Ok, then please define what you mean by COGs.

>This is the classic "we'll lose money per customer, but make it up in volume" argument.

You misunderstand the argument. Since I wasn't clear, these two articles highlight the main points:

https://www.kff.org/report-section/a-primer-on-medicare-how-...

https://www.washingtonpost.com/business/economy/medicare-pri...

Also with respect to these and the efficiency argument, please see:

https://theincidentaleconomist.com/wordpress/hospitals-medic...